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Editorial
Increased legalisation of medical assistance in dying: relationship to palliative care
  1. Joachim Cohen1 and
  2. Kenneth Chambaere1,2
  1. 1 End-of-Life Care Research Group, Vrije Universiteit Brussel (VUB) & Ghent University, Brussels/Ghent, Belgium
  2. 2 Department of Public Health and Primary Care, Ghent University, Gent, Belgium
  1. Correspondence to Professor Joachim Cohen, End-of-Life Care Research Group, 1090 Brussels, Belgium; jcohen{at}vub.be

https://doi.org/10.1136/bmjspcare-2022-003573

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    As medical assistance in dying (MAiD) is becoming a legal option in an increasing number of jurisdictions, palliative care (PC) organisations, services and practitioners are increasingly confronted with questions about how to morally, legally and practically position themselves towards MAiD. It is worth discussing experiences in contexts of legalised MAiD that shed light on the relationship between PC and MAiD.

    The PC vs assisted dying antagonism

    The relationship between PC and MAiD has often, if not predominantly, been portrayed as antagonistic. This was already articulated by pioneers of the hospice and PC movement such as Cicely Saunders in how euthanasia denies positive achievement in dying and how good PC is an antidote to euthanasia.1 2 Many PC practitioners and umbrella organisations such as the International Association for Hospice and Palliative Care3 and the European Association of Palliative Care4 5 continue to endorse this view.

    This fierce friction is surprising given the several goals that advocates of PC and MAiD share. An analysis of how both movements articulate what constitutes a good death has identified a shared underlying discourse with similar goals such as increasing people’s control over their dying circumstances, increasing autonomy through patient-centred care, maintaining dignity and reaching acceptance about death.6 Others have also indicated the common focus on avoiding suffering by both the PC movement and the MAiD movement.1 7 On the other hand, the friction can be understood as part of the political struggle between the two social movements and how they articulate control, autonomy, dignity and awareness quite differently.6

    Recurrent arguments for the antagonism between PC and MAiD refer to the philosophy and values of PC (eg, the view that its principles affirm life while regarding death as a natural process to be viewed without fear or sense of failure; death may be impossible to postpone …

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    Footnotes

    • Contributors Both authors have contributed to the conception and writing of this editorial and approved the final version.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; internally peer reviewed.